This application proposed to test the hypothesis that high levels of hostility, depressive symptoms, and stressful life events will be associated with all cause and cardiovascular disease (CVD) mortality after 16 years of follow-up in the Multiple Risk Factor Intervention Trial (MRFIT). MRFIT was a randomized, multicenter primary prevention trial designed to determine whether a special intervention consisting of smoking cessation, cholesterol reduction and control of high blood pressure, would result in a significant reduction in coronary heart disease (CHD) mortality, compared to usual care. The sample is composed of 12,866 men who at the time of study entry were in the top 15 percent of a risk score distribution based on the Framingham Heart Study data, but had no clinical evidence of CHD. During the trial, annual measurements were taken, which included some health behaviors, stressful life events, feelings of anger and hostility. A subset of 3,110 men also were administered once the Type A Structured Interview from which Potential for Hostility can be rated and all men who survived until the sixth year of the trial were administered the CES-Depression scale. After approximately 7 years of the active phase of the trial, the men have been followed for an additional 9 years for mortality and cause of death. To test the major study hypotheses, we will code all Type A Structured Interview tapes for Potential for Hostility, and components of hostility (Style, Intensity, Content) and we will construct and validate a self-report measure of hostility from items administered to all participants. Cox proportional hazard regression techniques will be used to test the association of hostility, depression, and stressful life events with all cause and CVD mortality. If the major study hypotheses are confirmed, then educational attainment, baseline risk factors, change in risk factors, and adherence indicators will be included in subsequent analyses. The proposed project presents a unique opportunity to test in a cost-efficient manner the association of psychosocial factors and mortality in a large, well characterized sample of middle-aged men.